Efficacy of infliximab in refractory posterior uveitis in Behcet's disease patients

• Published in: Egyptian rheumatologist 2018-04, Vol.40 (2), p.93-97
• Main Authors: El Garf, Ayman K., Shahin, Amira A., Shawky, Sherif A., Azim, Mohammed A., Effat, Dina A., Abdelrahman, Sherry K.
• Format: Article
• Language: English
• Subjects: Behçet’s disease; Infliximab; Posterior uveitis; Retinal vasculitis
• ISSN: 1110-1164; 2090-2433
• DOI: 10.1016/j.ejr.2017.08.001

Ocular manifestations are the main cause of morbidity in Behcet's disease (BD). Infliximab (IFX), a chimeric monoclonal antibody directed against tumor necrosis factor-alpha, may be efficient in refractory uveitis due to BD. The aim of this study was to assess the efficacy and safety of IFX in the treatment of patients with BD-associated refractory posterior uveitis (PU). Twenty patients with refractory Behcet's PU received IFX therapy as intravenous infusions at the dose of 5mg/kg at weeks 0,2, 6 (induction) and every 8weeks for a maximum of 6 infusions. The mean age of the patients was 31.8±9.1years, disease duration was 8±6years and 17 (85%) were males. After the third IFX infusion (week 8) a complete remission of PU was recorded in 8/20 (40%) patients and partial remission in 12/20 (60%) patients. At the end of week 32 a complete remission of PU was recorded in a total of 14 (70%) patients. The visual acuity of the 36 affected eyes (16 bilateral and 4 unilateral) showed a significant improvement at the week 8, and at week 32, while there was no additional improvement at week 56. Relapse occurred in 6 patients (30%) between week 9 and week 18 with a mean of 13.5weeks. IFX infusion should be considered for the control of acute PU, whereas repeated long-term IFX infusions were effective in reducing the number of episodes in refractory PU with fast regression and complete remission of complications.